Infection Control

Health care-associated infections (HAIs) constitute a risk to patients and health care facilities. Estimates indicate that 240,000 patients admitted to California hospitals annually develop HAIs, contributing to the suffering associated with illness and increasing costs to the health care system by approximately $3.1 billion. Literature suggests that a significant proportion of HAIs can be eliminated with intensive surveillance and prevention programs. CHA supports decreasing the number of HAIs through a deliberate and systematic approach that addresses infection-control program infrastructure and oversight. CHA also supports the public reporting of meaningful, scientifically valid information related to HAIs. The most prevalent HAIs (approximately 80 percent) are urinary tract infections, surgical-site infections, ventilator-associated pneumonia and central-line blood stream infections.

The HAI Advisory Committee- created by SB 739 (Chapter 526, Statutes of 2006) — recommends methods for preventing and reporting HAIs to the California Department of Public Health.

MEASLES
For the latest information on measles activity in California, visit the Department of Public Health's resource page.

Health care-associated infections (HAIs) constitute a risk to patients and health care facilities. Estimates indicate that 240,000 patients admitted to California hospitals annually develop HAIs, contributing to the suffering associated with illness and increasing costs to the health care system by approximately $3.1 billion. Literature suggests that a significant proportion of HAIs can be eliminated with intensive surveillance and prevention programs. CHA supports decreasing the number of HAIs through a deliberate and systematic approach that addresses infection-control program infrastructure and oversight. CHA also supports the public reporting of meaningful, scientifically valid information related to HAIs. The most prevalent HAIs (approximately 80 percent) are urinary tract infections, surgical-site infections, ventilator-associated pneumonia and central-line blood stream infections.

The HAI Advisory Committee- created by SB 739 (Chapter 526, Statutes of 2006) — recommends methods for preventing and reporting HAIs to the California Department of Public Health.

MEASLES
For the latest information on measles activity in California, visit the Department of Public Health’s resource page.

In All
Facilities Letter (AFL) 19-28, the California Department of
Public Health has announced a nationwide shortage of the
tuberculin skin test antigen Aplisol, as well as new guidelines
from the Centers for Disease Control and Prevention (CDC) for
tuberculosis screening of health care personnel. The notice also
reminds providers that an approved program flexibility is
required if a facility deviates from tuberculosis screening
requirements.

On July 18, the California Department of Public Health (CDPH)
released a California
Health Advisory Update on Ebola — one day after the World
Health Organization declared the Ebola outbreak in the Democratic
Republic of Congo to be a public health emergency of
international concern.

On July 1, the California Department of Public Health and the
Emergency Medical Services Authority deactivated the Medical
and Health Coordination Center, which was activated in response
to the April 2019 measles outbreak. Local health jurisdictions
are no longer required to submit weekly situation reports and
cost tracking related to the outbreak. Instead, they should
follow the defined response protocols in the Public Health and
Medical Emergency Operations Manual.

Last month, the Food and Drug Administration (FDA)
cleared a modified Erbe USA Inc. ERBEFLO 24-hour
multi-patient endoscope connector for use. The modified port
connector now includes a backflow prevention feature designed to
help reduce the risk of cross-contamination that was
previously identified in a letter from the FDA in April 2018.

Questions should be directed to the FDA’s Division of Industry
and Consumer Education at DICE@FDA.HHS.GOV, (800) 638-2041 or
(301) 796-7100.

With 21 measles cases reported in California this year, the
California Department of Public Health has offered detailed
recommendations – through
All Facilities Letter 19-17 – for identifying and
addressing the disease. The cases reported so far have
resulted in hundreds of investigations of possible contact
as well as transmission of the disease in emergency departments
and other health care settings.

Influenza activity remains high across the United States,
according to a
health alert recently issued by the Centers for Disease
Control and Prevention (CDC). The CDC notes that the season is
likely to last several more weeks and continues to recommend
antiviral medications for influenza treatment, regardless of
whether a patient received the influenza vaccine.

A new
health advisory from the California Department of Public
Health (CDPH) reminds providers to be aware of potential measles
cases, as 16 cases have been reported in California since
Jan. 1. CDPH notes that providers should not rule out a measles
diagnosis based solely on patients reporting they previously
received a measles immunization.

A new
health advisory from the Centers for Disease Control and
Prevention shares information about an investigation of a
penicillin-resistant strain of Brucella spreading across
the U.S. Suspected to be linked to consumption of unpasteurized
milk from a farm in Pennsylvania, cases have now been identified
in 19 states — including California. More information on the
infection and recommended treatment is available in the advisory.

In preparation for an
upcoming meeting to solicit stakeholder feedback on
possible changes to Title 22 infection control and physical
plant regulations for general acute care hospitals, the
California Department of Public Health has released a series of
questions. More details are available in All
Facilities Letter 18-56.1.

A
travel alert recently issued by the Centers for Disease
Control and Prevention notifies providers of recent cases of
surgical site infections in U.S. residents who underwent invasive
medical procedures in Tijuana, Mexico.

The Centers for Disease Control and Prevention has updated its
health alertaddressing a multistate outbreak of coagulopathy — a
bleeding disorder that impacts the way blood clots — that has
been linked to synthetic cannabinoid use.

According to an
annual report from the California Department of Public
Health, the overall vaccination rate among health care
personnel in California hospitals increased from 72 percent in
2012-13 to 84 percent in 2017-18, meaning that California is well
on its way to reaching the goal of 90 percent vaccination
coverage among hospital personnel by 2020.

Effective Jan. 1, 2020, general acute care hospitals and acute
psychiatric hospitals must adopt and implement a linen laundry
processing policy that aligns with the most recent standards from
the Centers for Disease Control and Prevention and the Centers
for Medicare & Medicaid Services.

In the attached All Facilities Letter 18-43, the California
Department of Public Health (CDPH) informs the public that CDPH’s
health care employees and surveyors are obligated to receive the
influenza vaccine or wear a mask inside designated patient care
areas. CDPH employees that receive a vaccine and provide
documentation to their district manager will receive a
verification sticker that should be affixed to their CDPH
identification badge.

The California Department of Public Health (CDPH) urges health
care providers to report cases in which patients experience acute
flaccid limb weakness. Nationally, 62 cases of acute flaccid
myelitis have been confirmed since the start of the year. This
rare neurological condition is characterized by sudden onset of
weakness in one or more limbs and distinct abnormalities in the
spinal cord. In the attached alert, CDPH provides guidance
related to case reporting and laboratory testing, as well as
precautions for infection control.

Yesterday, the California Division of Occupational Safety and
Health (Cal/OSHA) issued
guidance for health care employers on employee safety in
light of the hepatitis A outbreaks in San Diego, Santa Cruz and
Los Angeles counties. Cal/OSHA’s recommended
preventative measures include:

Following standard precautions such as maintaining a clean
and sanitary workplace, hand-washing and use of personal
protective equipment

Training at-risk employees in outbreak locations to
understand how hepatitis A is transmitted and how to prevent
infection

Offering hepatitis A vaccinations to employees in outbreak
locations who come into close contact with homeless persons or
anyone using illicit drugs, and to employees who handle
materials potentially contaminated with the hepatitis A
virus

It is also recommended that hospitals in outbreak areas remain in
contact with their local public health department to ensure they
have the most up-to-date information.